PrepU GI Agents
What is the correct rationale for why the nurse would administer a laxative at a separate time from the client's other medications?
Laxatives may reduce absorption of other drugs present in the GI tract
A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?
Proton Pump Inhibitors
The client has Maalox ordered for administration before meals. Which condition is contraindicated with the administration of Maalox?
Renal dysfunction
A client develops Clostridium difficile after receiving antibiotic therapy. The client asks the nurse how this occurs. Which is the nurse's best response? "
"By suppressing normal flora, antibiotics allow proliferation of the organism."
An older client has been prescribed omeprazole for the treatment of gastroesophageal reflux disease (GERD). What explanation should the nurse provide when asked by the client why they are not being treated with famotidine?
"Proton pump inhibitors, like omeprazole, produce fewer adverse effects among the older population."
A nurse is teaching a client about his prescribed lansoprazole. The nurse instructs the client to take the drug at which time?
1 hour before eating (as with all PPI)
A patient is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the patient's symptoms be abolished?
1-2 weeks
The nursing instructor is discussing the use of histamine2 receptor antagonists in the treatment of peptic ulcer disease. According to the instructor, which is a typical dosing schedule of famotidine during the first few weeks of treatment for gastric ulcer in patients with normal renal function?
20 mg bid
A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame?
30 minutes
When describing proton pump inhibitors, which would be appropriate to include?
Acid Labile PPI are rapidly absorbed from the GI tract. PPI are extensively metabolized by the liver. excreted in the urine
A nurse should screen a client for signs of which of the following medical conditions as the use of laxatives in these clients is contraindicated? Select all that apply:
Acute appendicitis
When administering a bulk laxative to a client, which action is important for the nurse to take?
Administer the laxative with a full glass of water or juice.
When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as LEAST common?
Alopecia
A nurse is teaching a client about diarrhea. Which statement by the client regarding diarrhea would indicate a need for additional teaching?
Diarrhea has no cure
The nurse should be aware that the combination of omeprazole and warfarin creates a risk of what adverse reaction?
Hemorrhage; Omeprazole increases levels of warfarin which creates risk for bleeding
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use extreme caution when administering cimetidine to clients with which condition?
Hepatic and renal disease
Which would be most important to include when teaching a patient about using psyllium?
Taking the agent with a large amount of water
After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?
I should eat an high fiber diet
A client arrives at the walk-in clinic reporting vomiting and a burning sensation in the midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?
Infection with H. pylori
Psyllium (Metamucil) is a bulk-forming laxative available over-the-counter and frequently used. The nurse knows that which of these statements regarding use of psyllium is correct?
Psyllium is useful in critically ill patients who experience constipation
Which is an important assessment for the nurse to make before administering a laxative?
Question the client regarding the type and intensity of symptoms to provide a baseline evaluation.
The following data identified during a nursing assessment and interview. When considering risks for the development of a peptic ulcer, which situation should the nurse discuss with the client?
Self medicates with a nonsteroidal anti-inflammatory drug (NSAID) daily.
What is the rationale for using two antimicrobials when treating a Helicobacter pylori infection?
Two antimicrobials are needed to prevent the emergence of drug-resistant H. pylori organisms.
Which teaching intervention is most important to share with the client prescribed misoprostol?
Use effective contraceptive measures. can cause abortion
The nursing instructor is teaching students about proper administration of sucralfate. According to the instructor, sucralfate should be administered:
an hour before meals
Because of the possible adverse effects of long-term proton pump inhibitor (PPI) use, the nurse practitioner should focus on what assessment in a 72-year-old client?
bone density
What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?
decreases production of gastric secretions
The nurse practitioner instructs the client to use over-the-counter ranitidine instead of cimetidine. What risk is decreased when using ranitidine rather than cimetidine?
drug to drug interactions
The health care provider has prescribed ranitidine for a hospitalized client on a unit. Prior to administering the drug for the first time, which adverse effects should the nurse mention to the client?
headache
The nurse should be aware that ranitidine achieves a therapeutic effect by which means?
inhibiting the secretion of gastric acid
A hospitalized client's request for a magnesium citrate "bisacodyl pill" every night to "keep regular" should alert the nurse to what potential health risk for the client?
laxative abuse
A male client tells the nurse that he takes antacid tablets several times each day. Knowing that the brand of antacid he uses contains calcium carbonate, the nurse cautions the client that overuse could place him at risk for:
metabolic alkalosis.
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
omeprazole; any proton pump inhibitor
A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to
pork
A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:
serum phosphate level.
What type of medication might be included in the medication therapy to treat a peptic ulcer by serving as a barrier to gastric secretions?
sucralfate
After teaching a group of students about H-2 receptor antagonists, the instructor determines that the teaching was successful when the students identify which drug as most appropriate for a patient with hepatic dysfunction?
Nizatidine is the drug of choice for patients with livver dysfunction because it does not undergo first pass metabolism in the liver like the other histamine 2 antagonists
A 35-year-old man is at his follow-up visit for GERD. Antacids have not been effective for his reflux, and the health care provider is prescribing a proton pump inhibitor. Why might the provider prescribe a PPI rather than an H2RA?
PPIs suppress acid more strongly and for a longer time.
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
Gynecomastia
Which of the following would a nurse expect as most likely to be used in combination with antibiotics for treatment of Helicobacter pylori infection?
Omeprazole